MRSO EXAM PREP

MRSO EXAM PREP MR Safety Officer responsibilities - CORRECT ANSWER-The role of MRSO is often carried out by the senior Radiographer (in the USA this will generally be an MR technologist), but other suitably trained individuals could also fill this role. Multiple MRSOs could be appointed, provided only one is in charge at a given time. His/her responsibilities include the following: To be readily accessible and available (eg, to the operators of the MR system) at all times that the MR facility is accessible. Ensuring that proper policies and procedures for day-today MR safety are enforced. Developing, documenting, and introducing, in conjunction with and under the authority of the MRMD/MRRD, safe working procedures for the MR environment. Ensuring that adequate written safety procedures, work instructions, emergency procedures, and operating instructions are issued to all concerned after full consultation with the MRMD/MRRD (and, if/as needed, the MRSE). Ensuring that appropriate measures for minimizing risks to health that arise from the use of or exposure to the MR equipment, as per the direction of the MRMD/MRRD, are implemented and monitored. Managing hazards posed by the MR equipment, and monitoring the measures taken to protect against such hazards. Ensuring that all Heads of Departments and senior medical staff members who are responsible for personnel who will be involved with the MR system are informed of the formal procedures for training and authorization. Ensuring that medical, technical, nursing, and all other relevant staff groups (including ancillary workers) who may be exposed to the MR environment are educated appropriately on a regular basis as to the safety requirements and updated as necessary. Maintaining records of the personnel who have been educated appropriately as to the safety requirements. Consulting the MRMD/MRRD (and/or the MRSE) when further adv Magnetophosphenes - CORRECT ANSWER-A Sensory Symptom where the subject sees flashing lights caused by an induced electrical current in the retina when exposed to a strong magnetic field. Bo - CORRECT ANSWER-Static magnetic field direction dBo/Dx - CORRECT ANSWER-Gradient magnetic field - Change in Magnetic Field / change in distance American Board of Magnetic Resonance Safety ABMRS provides MR Safety Credentialing for: - CORRECT ANSWER-MR Medical Director (MRMD) MR Safety Officers (MRSO) MR Safety Experts (MRSE) The MRMD certification is designed for: - CORRECT ANSWER-physicians, such as radiologists, who have responsibility for the safe administration of MR exams. The MRSO certification is designed for: - CORRECT ANSWER-those with a supervisory MRI safety role at the point of care. While not exclusive to technologists, this role is most frequently be filled by an MR technologist. The MRSE certification is designed for: - CORRECT ANSWER-those in an expert, technical consulting role who may help determine the safety of complex conditions. While not exclusive to MR medical physicists, this role is most frequently filled by a medical physicist. The following types of injury can and have occurred during the MRI scanning process: (8) - CORRECT ANSWER-1. "Missile effect" or "projectile" injury in which ferromagnetic objects (those having magnetic properties) such as ink pens, wheelchairs, and oxygen canisters are pulled into the MRI scanner at rapid velocity. 2. Injury related to dislodged ferromagnetic implants such as aneurysm clips, pins in joints, and drug infusion devices. 3. Burns from objects that may heat during the MRI process, such as wires (including lead wires for both implants and external devices) and surgical staples, or from the patient's body touching the inside walls (the bore) of the MRI scanner during the scan. (2) 4. Injury or complication related to equipment or device malfunction or failure caused by the magnetic field. For example, battery-powered devices (laryngoscopes, microinfusion pumps, monitors, etc.) can suddenly fail to operate; some programmable infusion pumps may perform erratically; (3) and pacemakers and implantable defibrillators may not behave as programmed. 5. Injury or complication due to failure to attend to patient support systems during the MRI. This is especially true for patient sedation or anesthesia in MRI arenas. For example, oxygen canisters or infusion pumps run out and staff must either leave the MRI area to retrieve a replacement or move the patient to an area where a replacement can be found. 6. Acoustic injury from the loud knocking noise that the MRI scanner makes. 7. Adverse events related to the administration of MRI contrast agents. 8. Adverse events related to cryogen handling, storage, or inadvertent release in superconducting MR imaging system sites. The most common patient injuries in the MRI suite - CORRECT ANSWER-Burns The most common objects to undergo significant heating - CORRECT ANSWER-Wires and leads. Objects associated with burns are: - CORRECT ANSWER-pulse oximeter sensors and cables, cardiorespiratory monitor cables, safety pins, metal clamps, drug delivery patches (which may contain metallic foil), and tattoos (which may contain iron oxide pigment). The American College of Radiology recommends that ________ and ____________ should be considered a relative contraindication for MRI - CORRECT ANSWERimplanted cardiac pacemakers implantable cardioverter/defibrillators Joint Commission checks that procedures are in place for the following safety hazards: - CORRECT ANSWER-Claustrophobic / Anxious patients Emergent patient needs Patients with implanted devices, embedded metal objects Prevention entry of ferromagnetic metal objects into the MRI environment Protecting patients from acoustic noise How many MRI Safety Zones? - CORRECT ANSWER-4 Classifications of Personnel: - CORRECT ANSWER-MR Personnel Level 1 Level 2 MR Medical Director MR Safety Officer Non-MR Personnel In which zone should patients change out of their street clothes? - CORRECT ANSWER-Zone 2 What takes place in Zone 2? - CORRECT ANSWER-Screening, changing, ferromagnetic detection.What is What takes placre in Zone 4? - CORRECT ANSWER-The Scanning. Personnel Designation Level 1: - CORRECT ANSWER-Those who have passed minimal safety educational efforts to ensure their own safety as they work within Zone III Level 1 MR personnel are not permitted to - CORRECT ANSWER-directly admit, or be designated responsible for, non-MR personnel in Zone IV. Level 2 MR Personnel - CORRECT ANSWER-Those who have been more extensively trained and educated in the broader aspects of MR safety issues, including, for example, issues related to the potential for thermal loading or burns and direct neuromuscular excitation from rapidly changing gradients It is the responsibility of the _________not only to identify the necessary training, but also to identify those individuals who qualify as level 2 MR personnel - CORRECT ANSWER-MR medical director It is understood that the medical director will have the necessary education and experience in MR safety to qualify as: - CORRECT ANSWER-level 2 MR personnel Non-MR personnel will be the terminology used to refer to: - CORRECT ANSWER-any individual or group who has not within the previous 12 months undergone the designated formal training in MR safety issues defined by the MR safety director of that installation. Zone III regions should be physically restricted from general public access by: - CORRECT ANSWER-key locks, passkey locking systems, or any other reliable, physically restricting method that can differentiate between MR personnel and non-MR personnel Secured Access: Only ____________ shall be provided free access, such as the access keys or passkeys, to Zone III. - CORRECT ANSWER-MR personnel Non-MR personnel should be ____________ within Zone III or IV restricted regions. - CORRECT ANSWER-accompanied by, or under the immediate supervision of and in visual or verbal contact with, one specifically identified level 2 MR person for the entirety of their duration Patients should be screened and changed in zone - CORRECT ANSWER-2 Who is responsible for the safe execution of an MRI procedure? - CORRECT ANSWER-It's the radiologist / MR Medical Director Any area 5 gauss or higher is zone ________ and must have _________ access - CORRECT ANSWER-4 - restricted access Magnetic Sheilding ____________________ the magnetic field - CORRECT ANSWERreshapes Zone 4 should be clearly marked and have a lighted sign stating: - CORRECT ANSWER-THE MAGNET IS ALWAYS ON Verify all objects brought into zone 4 are non-ferrous with a - CORRECT ANSWER1000 gauss handheld magnet Objects within zones 3 & 4 should be tested and clearly ___________ - CORRECT ANSWER-labeled "The results of such (portable metallic/partially metallic object) testing, as well as the date, time, and name of the tester, and methodology used for that particular device, should be documented in writing. If a device has not been tested, or if its MR compatibility or safety status is unknown, it should not be permitted unrestricted access to Zone ____." - CORRECT ANSWER-documented in writing / 3 Conventional fire extinguishers - CORRECT ANSWER-are not permitted in zone 3 In the event of a fire, a quench should _________________ - CORRECT ANSWER-not necessarily be required. If firefighters and equipment need to enter into Zones 3 or 4, _________________ personnel should remain and initiate a quench and verify the magnetic field is ________________ - CORRECT ANSWER-MR Level 2 / no longer detectable or a hazard. In the event of a fire, remove _____________ to the MRI equipment - CORRECT ANSWER-power Immediately remove the patient and anyone else in the room in the event of a ______ - CORRECT ANSWER-quench Quench safety considerations: - CORRECT ANSWER-Primary vent system failure : Asphyxiation, pressure lock, liquefy the air creating highly flammable liquid oxygen Loud boom causing ruptured ear drums In the event of a quench, immediately remove: - CORRECT ANSWER-anyone inside the room Quench vent pipes should be inspected: - CORRECT ANSWER-annually Screening and patient prep should be performed in which zone? - CORRECT ANSWER-2 Screening for patients and support persons should be - CORRECT ANSWER-identical, but with less clinical information for support person. Simplifying the screening form - CORRECT ANSWER-increases risk to the patients. How should unresponsive patients be screened? - CORRECT ANSWER-Physical exam, looking for scars, x-rays of skull, orbits, chest, KUB to detect implanted devices, prior reports in chart The technologist who is performing the MR exam should interview / screen the patient - CORRECT ANSWER-verbally and interactively Never assume in case of a hand-off that the patient was previously - CORRECT ANSWER-screened properly. Patient dress for MRI exams: - CORRECT ANSWER-all removable objects removed, change into MRI provided attire. Some fabrics contain ______________ and can ____________ during MRI exam - CORRECT ANSWER-metallic fibers / catch fire Drug patches in the area of a transmit / receive coil should be - CORRECT ANSWERremoved prior to scan . ACR Guidelines for orbit screening: - CORRECT ANSWER-"All patients who have a history of orbit trauma by a potential ferromagnetic foreign body for which they sought medical attention are to have their orbits cleared by either plain X-ray orbit films (2 views) or by a radiologist's review and assessment of contiguous cut prior CT or MR images (obtained since the suspected traumatic event) if available." ACR Guidance on MR Safe Practice Pg 6 FDA - MRI Safety during pregnancy - CORRECT ANSWER-FDA - The safety of MR imaging during pregnancy has not been proved.